A 4-year-old child has been diagnosed with congestive heart failure because of an opening in the atrium that occurred before birth. The nurse realizes this client is experiencing:
1. Ventricular septal defect.
2. Pulmonary atresia.
3. Atrial septal defect.
4. Complete atrioventricular canal.
3. Atrial septal defect.
Rationale:
Atrial septal defect is the defect that results when the foramen ovale remains open during fetal development. The development of congestive heart failure in a young child is one manifestation of the disorder. A ventricular septal defect is an opening between the right and left ventricle, and oftentimes the only indication that it is present is a murmur. Pulmonary atresia is the absence of intact structures between the pulmonary artery and the right ventricle. With this condition, cyanosis is present upon birth. An atrioventricular canal involves an atrial septal defect that connects with a ventricular septal defect, and is lower in the atrial septum than the foramen ovale. A baby with this disorder would demonstrate tachycardia, poor growth, respiratory infections, and respiratory failure.
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